Aids Patients Learn To Live As Drugs Improve Outlook

The rare and mysterious ailments began killing young gay men in South Florida in 1981, soon after doctors in New York City and San Francisco had begun sounding an alarm.

Once-healthy men in the prime of life were wasting away, their bodies unable to shake off strange skin cancers or weird infections normally seen only in cats or other animals.

It was two more years before the doctors knew what they were fighting -- a new virus that wipes out the body`s immune system. They had begun the long battle against AIDS.

In those early days, before acquired immunodeficiency syndrome even had a name, the bewildered doctors fought the infections as best they could. The patients went on dying, sometimes long and painful deaths. Little could be done for them.

Now, in the ninth year of battle against the virus, with AIDS cases in the United States approaching the 100,000 mark, that has changed.

New life-prolonging treatments are making their way into widespread use across the United States. More drugs are showing promise in human tests.

For the first time, leading AIDS doctors and researchers are speaking cautiously of patients living longer and enjoying better lives. The new hope is for treating infection with the AIDS virus as a chronic illness -- of patients learning how to live with AIDS, not just dying of it.

``We now have drugs ... that can prevent a lot of the opportunistic infections that claimed these lives,`` said Dr. Ron Wiewora, who treated some of Palm Beach County`s earliest cases. ``There is every reason to be hopeful.``

Wiewora said that if human immunodeficiency virus is diagnosed early enough, doctors can monitor the patient`s immune system and ward off serious infections with drugs now available. HIV can take as long as 10 years to produce AIDS symptoms.

Project Inform, a San Francisco-based AIDS information agency, earlier this year wrote in a report to its members about advances in treatment: ``With early intervention, people with HIV infection will not have to face an automatic death sentence.``

Rollins Mahony III, 38, a West Palm Beach man diagnosed with the virus in late 1987, said the new drugs and new hope ``are a constant topic of conversation`` among people with AIDS.

``We are taking the best possible care of ourselves, taking our medication, getting proper nutrition, taking vitamin supplements and thinking positive thoughts because we know there will be a better drug, and then a better drug after that, and eventually there will be a cure,`` said Mahony, a member of the People with AIDS Coalition. ``We just have to try to hold on until that happens.``

There is more good news for people such as Mahony.

Recent studies show the rate of new infections among homosexual men is leveling off in some parts of the country because they learned early in the epidemic how to protect themselves from the virus.

But the news is tempered by alarming new figures showing that the virus is spreading rapidly among intravenous drug users, the heterosexual poor and their babies in the nation`s inner cities, people far less educated and organized to battle it than the gay community.

``We in the gay community said eight years ago that it was not a gay disease,`` Mahony said. ``We just happened to be the ones in the U.S. who got it first. The virus was out there and anyone who was sexually active over the past decade could be at risk.``

A federal Centers for Disease Control study released in February found that both the number of AIDS cases and the rate of growth in new infections have skyrocketed in Florida, which ranks third in the nation behind California and New York with 7,351 AIDS cases as of April 1. An estimated 160,000 others in the state are infected with the virus.

DOCTOR APPALLED BY SPREAD

Dr. Harold W. Jaffe, chief of AIDS epidemiology at the CDC in Atlanta who has watched the progress of the disease since its beginnings, is appalled that it continues to spread.

At the same time, he is encouraged by new drug therapies that are prolonging lives.

Jaffe cited the drug pentamidine -- an antibiotic long used to treat pneumonia and other infections -- as perhaps the most important innovation in keeping AIDS patients alive. The new twist is that instead of taking pentamidine by injection, patients breathe an aerosol version of the drug directly into their lungs once or twice a month. The drug has proved successful in preventing the single biggest killer of AIDS patients -- pneumocystis carinii pneumonia.

Aerosol pentamidine, approved in February by the U.S. Food and Drug Administration under the designation ``investigational new drug,`` has been shown effective in preventing the pneumonia that used to hit 65 percent of AIDS patients.

An 18-month San Francisco study of 256 patients who had had one bout of the often-fatal pneumonia showed that 10 percent had a second bout after nine months of inhaling the drug on a regular basis. A 45 percent recurrence rate was reported in patients who did not use the drug.